Karl Jessica A, Ouyang Bichun, Colletta Kalea, Verhagen Metman Leo
Movement Disorder Section of Neurological Sciences, Rush University Medical Center, 1725 W. Harrison Street, Suite 755; Chicago, IL 60612, USA.
Department of Neurological Sciences, Loyola University Medical Center, 2160 S. 1st Ave.; Maywood, IL 60153, USA.
Brain Sci. 2018 Apr 1;8(4):60. doi: 10.3390/brainsci8040060.
Bilateral subthalamic nucleus (STN) deep brain stimulation (DBS) is an effective and proven treatment option for patients with advanced Parkinson's disease (PD). Long-term outcomes (>5 years) have demonstrated sustained improvement in objective motor symptoms; however, few studies have evaluated patient-centered outcomes other than quality of life (QOL). A locally developed DBS-patient-centered outcomes questionnaire was administered to PD patients >5 years post-DBS. All questions were scored on a ten-point scale, whereby 0 represented the most 'positive' answer and 10 the most 'negative' answer. Pre-operative scales were repeated at the time of survey. Fifty-two patients (mean 8.2 ± 2.6 years post-DBS) were included. Satisfaction was high with median score (range) of 1/10 (0-8) at the time of survey. Patients endorsed having made the correct decision by undergoing DBS, with a score of 0 (0-10), would choose to have DBS again, with a score of 0 (0-10), and would recommend DBS to others, with a score of 0 (0-10). Pre-operative expectation target was set at a high level with a score of 2 (0-10). Parkinson's Disease QOL (PDQ-39) Questionnaire Summary Index (SI) scores were, mean (SD), 2.1 (18.2) above baseline ( = 0.44). Those with worsening in PDQ-39-SI scores had less satisfaction with DBS ( = 0.57, ≤ 0.0001). This is the first study to assess long-term patient satisfaction with STN DBS. We are currently collecting data prospectively to confirm the results of these preliminary findings.
双侧丘脑底核(STN)深部脑刺激(DBS)是晚期帕金森病(PD)患者一种有效且已得到证实的治疗选择。长期结果(>5年)显示客观运动症状持续改善;然而,除生活质量(QOL)外,很少有研究评估以患者为中心的结果。对DBS术后超过5年的PD患者进行了一项本地开发的以DBS患者为中心的结果调查问卷。所有问题均采用十分制评分,其中0代表最“积极”的答案,10代表最“消极”的答案。术前量表在调查时重复使用。纳入了52名患者(DBS术后平均8.2±2.6年)。调查时满意度较高,中位数评分为1/10(范围0 - 8)。患者认可接受DBS是正确的决定,评分为0(0 - 10),会再次选择接受DBS,评分为0(0 - 10),并会向他人推荐DBS,评分为0(0 - 10)。术前期望目标设定为较高水平,评分为2(0 - 10)。帕金森病生活质量(PDQ - 39)问卷总结指数(SI)得分平均(标准差)比基线高2.1(18.2)(P = 0.44)。PDQ - 39 - SI得分恶化的患者对DBS的满意度较低(P = 0.57,r≤0.0001)。这是第一项评估STN DBS长期患者满意度的研究。我们目前正在前瞻性地收集数据以证实这些初步发现的结果。